Individual
MR. CHARLES HENRY GREENE III
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS, PT, ATC
Contact information
Practice address
203 S POLK ST, ALBANY, MO 64402-1618
(660) 726-5762
(660) 726-5764
Mailing address
203 S POLK ST, ALBANY, MO 64402-1618
(660) 726-5762
(660) 726-5764
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
104902
MO
225100000X
Physical Therapist
1101879
KS
2251S0007X
Sports Physical Therapist
104902
MO
2255A2300X
Athletic Trainer
Primary
1068862
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25783024
BLUE CROSS BLUE SHIELD
MO
Enumeration date
06/10/2006
Last updated
09/11/2025
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